胰管结石的诊治(附17例报告)

目的:探讨胰管结石的诊治和手术方式的选择.方法:回顾分析我院收治的胰管结石17例.结果:17例中常见的临床症状是腹痛(100%),食欲不振及恶心呕吐(62.5%),脂肪泻(12.5%),消瘦(17.6%).胰管扩张及胰管结石的B超诊断率分别为88.2%和76.5%,胰管结石的CT和MRI诊断率均为71.4%,ERCP胰胆管显影者60%.手术方式包括胰管切开取石、胰管空肠Roux-en-y吻合术10例,胰十二指肠切除术2例,胰体尾切除术1例,胆总管空肠Roux-en-y吻合术1例.结论:胰管结石以B超检查为首选,与CT、MRI、ERCP等检查联合使用基本上能确诊.治疗以手术为主,严格掌握手术适应证和选择合理的手术方式,对胰管结石的治疗具有重要意义.

Diagnosis and Treatment of pancreatolithiasis (with 17 Cases Attached)

Objective:To investigate the diagnosis and seletion of surgical treatment for pancreatolithiasis.Methods:17 patients with pancreatolithiasis from 1996 to 2006 were analyzed retrospectively.Results:The common symptom of pancreatolithiasis were abdominal pain(100%),loss of appetite and nausea and vomiting(62.5%),fatty diarrhea(12.5%),emaciation(17.6%).The diagnosis rate of B-mode ultrasonography for pancreatic stone and for pancreatic duct dilation was 88.2% and 76.5%;the diagnosis rate for CT and MRI scan were 71.4%,and for ERCP was 60%.The operation for pancreatolithiasis includes Roux-en-Y pancreatojejunostomy of 10 patients,pancreatoduodenectomy of 2 patients,and distal pancreatectomy of 1 patient,Roux-en-Y choledochojejunostomy of 1 patient.Conclusion: B-mode ultrasonography is the chief check or pancreatolithiasis,patients can be diagnosed associated with CT,MRI,ERCP.Operation is the main treatment,strictly selecting an indication and surgical produre,which has important significance to panreatolithiasis treatment.